Scoping review of published research on medical education in India during the Covid-19 pandemic

BACKGROUND Medical educators in India made rapid adjustments to maintain continuity and integrity of medical education in the midst of disruption caused by the Covid-19 pandemic. However, there are concerns regarding achievement of competence by undergraduate medical students due to inadequate clinical exposure. We explored the focus of initiatives from medical educators in India by a scoping review of published articles on developments in medical education during the pandemic to map concepts, main sources and the literature available in PubMed. METHODS We did this scoping review of published articles in PubMed database in four steps: (i) identification of research questions; (ii) identification of relevant studies; (iii) selection of studies meeting inclusion and exclusion criteria, and charting of data; and (iv) collating the summary and reporting of results. Manual content analysis was done to derive frequencies of variables. RESULTS Of the 52 articles identified, 22 met the requirements. Most studies (68.2%) were published in 2020. Half of the studies were conducted among undergraduate students and the remaining among postgraduates (27.3%), faculty (18.2%) and interns (4.5%). All the studies were evaluations at Kirkpatrick level-1 (18; 81.8%) and level-2 (4; 18.2%). Most of the studies (9, 41%) focused on exploration of perspectives about online learning among students and faculty, 9 (27.3%) on teaching– learning, 4 (18.2%) on formative assessment and 3 (13.6%) on summative assessment. CONCLUSIONS Most studies were evaluations at Kirkpatrick level-1 and level-2 among undergraduate medical students with a focus on conceptual understanding.

Regulatory system to promote the culture of quality at Indian medical schools: Are we doing enough?

The replacement of the Medical Council of India (MCI) with the National Medical Commission (NMC) was an important change in regulatory oversight to bring about transparency in regulatory procedures for improving quality of medical education and meeting the needs of healthcare in India. Similarly, due to globalization of medicine including migration of health workforce and desire to raise standards of medical education and healthcare, efforts have progressed well towards transnational regulation and establishment of an overarching body, which recognizes regulatory agencies for their adherence to good practices. We describe the global collaborative efforts to improve the quality of medical education by the promotion of accreditation through the recognition programme of the World Federation of Medical Education (WFME), the publication of the expert consensus standards across the continuum of medical education and the Guidelines for Accreditation of Basic Medical Education. We also highlight that many medical schools across the world have adopted the WFME standards and many regulatory and accrediting agencies have achieved recognition status. Based on appraisal of the NMC Act and notification on minimum standard requirements (MSRs) for medical colleges, we point out the gaps between the intent stated in the preamble of the NMC Act and the notification on MSRs. We recommend a way forward to develop a regulatory model and approaches that match NMC’s stated intent and meet the requirement for medical schools in India to gain international recognition.

Experience of a faculty development workshop in mentoring at an Indian medical college.

Background. Our medical college is running a mentoring programme for undergraduate medical students since 2009. The academic leadership of the college identified the need to change the focus of the programme from mere problemsolving to professional and personal development of mentees. Methods. A core group of mentors designed and implemented a workshop on mentoring for 28 students. The workshop included reflections on the participants’ previous experiences about mentoring, discussion on perceptions of mentees about the existing mentoring programme, self-analysis of mentoring skills, overview of the Surrendering, Accepting, Gifting and Extending (SAGE) model and demonstration of effective mentoring skills using role plays and a film. We collected written anonymous feedback from participants at the end of the workshop to elicit their responses regarding various aspects of the programme, change in their views about mentoring and suggestions for future workshops. Results. A majority of the participants (17, 60.7%) said that role plays and reflection on role plays were the most valuable part of workshop as they provided clarity on the concepts about mentoring. The most frequently identified take-home messages were: building trust with the mentee (7, 25%), balance in life and approach towards the mentee (6, 21.4%), and understanding that mentoring is a process geared towards personal and professional development of the mentee (6, 21.4%). Conclusion. The participants’ reaction to the workshop was positive. The responses of participants suggested that the workshop was successful in changing their views regarding the purpose of the mentoring programme. Natl Med J India 2016;29:286–9

Educational intervention to improve death certification at a teaching hospital.

Background. Information recorded in the ‘cause of death’ section of death certificates is an important source of mortality statistics. It is used for policy decisions, development of healthcare programmes and health research. Errors in death certificates can lead to inappropriate allocation of resources. Errors are universal and have been reported previously. We planned an educational intervention aimed at resident doctors from various specialties at our teaching hospital to improve the accuracy of the ‘cause of death’ section in death certificates. Methods. Three workshops, each of 90 minutes, were conducted for residents. A total of 198 death certificates (96 before and 102 after intervention) were audited. We compared the frequency of major and minor errors before and after the educational intervention. Results. Following the educational intervention, there was a significant decrease in major errors such as unacceptable underlying cause of death (39.6% v. 24.5%, p=0.034), reporting of mechanism without underlying cause of death (13.5% v. 1%, p=0.001) and improper sequencing of events (25% v. 6%, p=0.004). There was no significant decrease in minor errors such as absence of time intervals, use of abbreviations and reporting a mechanism with a legitimate cause. Conclusion. Both major and minor errors are common in death certification at teaching hospitals. Educational interventions can improve the accuracy of reporting in death certificates.

Sensitizing faculty to the problem-oriented approach as an instructional method: experience of a brief faculty development workshop.

BACKGRAUND: The Medical Council of India has recommended that the learning process should include a problem-oriented approach and case studies in addition to other teaching-learning methods. The medical education unit at our college planned a workshop to enable the faculty to acquire the role of a facilitator; a role different from that of a conventional teacher. METHODS: A core group of in-house faculty who had previous exposure to problem-based learning (PBL) and external experts planned the 2-dayworkshop. Participants were administered a pre- as well as post-test questionnaire on understandingofPBL and asked to provide feedback on their experience. A week later a second workshop on creating effective case scenarios was conducted and feedback was obtained. RESULTS: About 92%-96% of participants felt that the PBL workshop helped them to understand the meaning of PBL, steps of PBL, importance of group dynamics and student responsibilities in PBL. Thirty-two percentstated thattheworkshop did nothelpthem in understanding the role of a good PBL facilitator. CONCLUSION: Two faculty development workshops created awareness and understanding of PBL and case writing for PBL among our faculty who were trained in the traditional system of teaching. However, responses from the faculty suggested that a workshop focused on developing facilitator skills would be essential to enable them to emerge as facilitators of group learning ratherthan providers of information.